【摘要】 目的 探讨64层螺旋CT三维重建在气管、主支气管肿瘤诊断中的应用价值。方法 39例均接受64层螺旋CT胸部扫描,工作站行气管、支气管三维重建,仿真内窥镜,多平面重组,最小密度投影重建。分析气管、支气管肿瘤的CT表现,并与手术病理和支气管镜检结果进行比较。结果 肿瘤位于气管9例,左主支气管13例,右主支气管15例,病变广泛2例。所有病例均见管腔内充盈缺损影,致管腔1级狭窄1例,2级狭窄0例,3级狭窄14例,4级狭窄24例。管壁无增厚2例,管壁增厚14例,壁厚伴向轮廓外突出23例。宽基底32例,窄基底7例。边缘光滑2例,边缘不规则37例。良性肿瘤3例:良性间叶瘤、平滑肌瘤、多形性腺瘤各1例。恶性病变36例:小细胞未分化癌8例,腺癌1例,鳞状细胞癌25例,黏液表皮样癌1例,甲状腺乳头状癌1例。与病理比较本研究正确诊断率为97.44%,与支气管镜检比较仿真内窥镜对病变近端的显示与支气管镜所见均一致。结论 64层螺旋CT三维重建是气管、主支气管良恶性肿瘤诊断与鉴别诊断、支架植入计划和疗效评价的方便、无创、准确的检查方法。更多还原

【Abstract】 Objective To evaluate the roles of 64-slice spiral CT with multiplanar and three-dimensional reconstructions in the diagnosis of tracheobronchial tumor.Methods 39 cases were undergone CT scan for chest using TOSHIBA Aquilion 64 or PHILIPS Brilliance 64 system.The post-processing techniques included volume rendering(VR),virtual bronchoscopy(VB),multiplanar reconstruction(MPR),minimum intensity projection(MinIP) in Vitrea 2 workstation.The CT manifestations were analyzed,and compared with the results of the operation and bronchoscopy.Results The tumor located in trachea in 9 cases,right main bronchus in 15 cases,left main bronchus in 13 cases.The tumors were in large airway widely in 2 cases.All of cases showed the filling defect in airway.The degree of lumen stenosis was the first grade in 1 case,the second grade in 0 case,the third grade in 14 cases,the forth grade in 24 cases.The thickening of the walls of the trachea or bronchus in 14 cases,both thickening of the walls and extraluminal extensions in 23 cases,there was not any thickening of the walls in 2 cases.The edge of the tumor showed smooth in 2 cases,irregular in 37 cases.Benign tumor was in 3 cases,including benign mesenchymoma,leiomyoma,and pleomorphic adenoma in 1case,respectively.Malignant tumor was in 36 cases,including small cell carcinoma in 8 cases,adenocarcinoma in 1 case,squamous cell carcinoma in 25 cases,mucoepidermoid carcinoma in 1 case,papillary thyroid cancer in 1 case.The diagnostic accuracy was97.44% using of 64-slice spiral CT with multiplanar and three-dimensional reconstructions.Conclusion 64-slice spiral CT with multiplanar and three-dimensional reconstructions is a valuable method in the diagnosis and the differential diagnosis of the tracheobronchial benign and malignant tumors,stent planning and follow-up.更多还原